Intraoperative Importance of Low Dose Intradural Spinal Anaesthesia of Pre�eclamptic Patients on Treatment with Magnisium Sulphate Therapy in Emergency Caesarean Section

Dr. Shukla Chetan; Dr. Shringi Kiran Lata; Dr. Kalani Sanjay

Volume : VI, Issue : X, October - 2016

Intraoperative Importance of Low Dose Intradural Spinal Anaesthesia of Pre�eclamptic Patients on Treatment with Magnisium Sulphate Therapy in Emergency Caesarean Section

Dr. Shukla Chetan, Dr. Shringi Kiran Lata, Dr. Kalani Sanjay

Abstract :

Objective: Pre–eclamptic patients have chances of seizures, congestive heart failure, renal failure, pulmonary oedema, HELLP syndrome, and encephalopathy. Termination of pregnancy is the only treatment for reduce maternal mortality. In pre–eclampsia the patient is hypovolumic due to intense vasoconstriction and in spinal anaesthesia chances of vasodilatation due to sympathetic cut down. In emergency cesarian section if conducted in intradural spinal anaesthesia with low dose bupivacaine and fantanyl provides less hyper dynamic changes, quick effects of anaesthesia in less time consuming procedure. Prophylactic magnesium sulfate therapy provides protection against seizures with many other benefits of magnesium which is discussed in this study. Results: it is observed that blood pressure and heart rate changed less likely from base line value in low dose spinal intradural (subarachnoid) anaesthesia in pre–eclamptic patients on magnesium sulphate therapy and same has been checked and justified by applying t–test. Conclusion: Magnesium sulphate therapy protects patients against seizures intraoperatively as well as postoperatively. Protect against complications like hypertension , intracranial haemorrhage, cardiac arrhythmia also give cellular protection during ischaemia, reduce reperfusion injury by inhibiting calcium overload, reduce ischaemic damage and traumatic ain injury, act as a adjuvant in standard onchodilator therapy. [10] With prophylactic magnesium sulphate therapy in pre–eclamptic patients undergoing surgery in Spinal anaesthesia (intradural) mean blood pressure and heart rate remains settled with proper fluid preload. Heavy Bupivacaine 0.5% with fentanyl were used as anaesthetics . Postoperative morbidity and mortality are also less in intradural spinal anaesthesia in this study